DIRECTOR PATIENT FINANCIAL SERVICES

The Director Patient Financial Services will organize and oversee patient billing, collections, denials and underpayments, correspondence, insurance verification, and admitting/patient registration (patient access).  This position will function as the key contact for resolution of issues with contract billing services and hospital financial services.

Primary Functions include:

1. Assists with periodic audits by state, county, external and third-party contracted auditors, or fiscal intermediaries. Ensures that billing and collection activities are compliant with current county, state, and federal regulations.
2. Assists with meeting revenue cycle performance goals and metrics.  Assigns billing and follow-up productivity to individual staff.  
3. Evaluates the performance and effectiveness of subordinate staff, develops staff and management skills, sets goals and objectives, and performs ongoing evaluation of departmental operations to ensure maximum efficiency and effectiveness.  Trains and acts as mentor to staff on departmental best practices.
4. Ensure timely and accurate cash posting and application of accounts receivables adjustments, write-offs, and account transfers. Approves write-off, adjustments and refunds as defined by policy.
5. Maintains appropriate programs to ensure a high level of customer satisfaction that includes patient friendly billing techniques, prompt service recovery and creation of an ideal patient experience. Investigates and promptly resolves patient problems or reported service dissatisfaction.
6. Participates in the implementation of new and updated departmental information systems; identifies and communicates system related problems, to relevant staff and departments.
7. Stay abreast of changing government billing regulations, new programs and revenue opportunities. Ensures that staff are current with required codes, bill forms, electronic claims processing tools and documentation rules.
8. Oversees patient billing and collection activities including accounts receivable management, third party payer follow-up, claim submission, third party vendor management, appeals, and payment posting.  Communicates with federal, state, and local agencies (Noridian) regarding issues related to billing / remittances.
9. Manages daily operations of patient access process ensuring gathering of appropriate demographic information, appropriate insurance verification, timely authorizations, collection of appropriate co-pays.
10. Understands and applies third party payor contracting terms, oversees claims editing system edits and rules, monitors actual payments and denials against contractual terms and works with payers to reconcile under or over payments.
11. Assures the Hospital is receiving appropriate payment for services provided.  Reviews and projects expected payments by payor.
12. Participates in meetings with departments and revenue enhancement staff to ensure compliance with all supporting documentation necessary for successful claims submission and reimbursement.
13. Provides hands-on support with billing / follow up and TARS processing.   Backs up staff as needed.

• Bachelor's Degree in related field or equivalent work experience.
• Five (5) years progressive experience in a healthcare business office environment.
• Understanding of Revenue Cycle related to healthcare patient financial services.
• Working knowledge of patient financial systems, Meditech preferred.
• Working knowledge of federal, state, and local regulations regarding patient billing, collections, appeals, and patient access.
• Excellent customer service skills
• Ability to speak, read, write and communicate effectively in English.
• Ability to coordinate, analyze, observe, make decisions and meet deadlines in a detail-oriented manner.
• Proficient computer skills (Microsoft Office and Microsoft Outlook).
• Previous experience with hospital billing systems (MediTech and Claims Source preferred).